title: Impact of total retrieved lymph nodes on staging and survival of patients with gastric cancer invading the subserosa.
abstract: OBJECTIVE
  To investigate the impact of total retrieved lymph nodes (tLNs) on staging and survival in patients with pT2b gastric cancer according to the nodal status.
  
  
  METHODS
  Clinicopathological characteristics and prognostic outcomes of 392 patients with pT2b gastric cancer between 1980 and 2005 were retrospectively investigated based on the nodal status.
  
  
  RESULTS
  The number of metastatic lymph nodes (mLNs) was highly correlated with the number of tLNs (P<0.001). The overall 5-year and 10-year survival rates were 39.0% (153/392) and 17.9% (70/392), respectively. The survival rates in patients with pN0 cancers did not differ significantly from that in patients with pN1 cancer when the tLNs were 25 or less. However, the survival rate in patients with N0 cancers was significantly greater than that in patients with pN1 cancers when the tLNs were more than 25 (64.3% vs. 36.9%, chi(2)=4.339, P=0.037). Moreover, both 5- and 10-year survival rates differed significantly among patients with pN1, pN2 and pN3 gastric cancer regardless of tLNs. Multivariate analysis revealed that age, tumor focus number, tumor location, and mLN, but not tLNs, were independent prognostic predictors in patients with pT2b gastric cancer.
  
  
  CONCLUSIONS
  To improve the accuracy of staging, no less than 15 tLNs should be pathologically examined in patients with pN1-3, and 25 tLNs for the patients with N0. More tLNs may not be associated with a better prognosis in pT2b disease because the extent of lymph node dissection is pre-defined for the operation.
authors.affiliation: Department of Oncology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province 110001, China.
authors.forename: Caigang
authors.initials: C
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.forename: Zhu
authors.initials: Z
authors.lastname: Jun
authors.forename: Ruishan
authors.initials: R
authors.lastname: Zhang
authors.forename: Fan
authors.initials: F
authors.lastname: Yao
authors.forename: Ping
authors.initials: P
authors.lastname: Lu
authors.forename: Feng
authors.initials: F
authors.lastname: Jin
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.forename: Huimian
authors.initials: H
authors.lastname: Xu
authors.forename: Shubao
authors.initials: S
authors.lastname: Wang
authors.forename: Junqing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016564:Amyloid beta-Protein Precursor; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D058255:Protease Nexins; D011956:Receptors, Cell Surface; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology*; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D016564:Amyloid beta-Protein Precursor; D058255:Protease Nexins; D011956:Receptors, Cell Surface